Left temporal low-frequency rTMS for the treatment of tinnitus: clinical predictors of treatment outcome - a retrospective study
Left temporal low-frequency rTMS for the treatment of tinnitus: clinical predictors of treatment outcome - a retrospective study
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DOI：
10.1111/j.1468-1331.2010.02956.x
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发表时间：
2010-07-01
影响因子：
5.1
通讯作者：
Langguth, B.
中科院分区：
文献类型：
--
作者：
Frank, G.;Kleinjung, T.;Langguth, B.
背景：越来越多的证据表明，重复经颅磁刺激（rTMS）可以减少慢性耳鸣。然而，治疗结果的特点是高度的个体差异。因此，确定治疗反应的预测因素具有很高的临床相关性。方法：对194例耳鸣患者的临床资料进行分析。所有患者均采用标准化的rTMS程序（1 Hz， 10天，2000刺激/天，左侧颞叶皮层）进行治疗。分析以下参数对结果的潜在影响：年龄、性别、rTMS前贝克抑郁量表（BDI）抑郁评分和耳鸣严重程度（TQ）、耳鸣偏侧、频率和持续时间以及听力损失程度。结果：观察其对耳鸣侧耳的影响。在左侧或双侧耳鸣患者中，rTMS导致TQ评分有统计学意义的降低，而右侧耳鸣患者在rTMS治疗后没有显着改善。然而，在相关分析中，我们发现在治疗应答亚组中耳鸣持续时间影响rTMS结果的趋势没有达到统计学意义。此外，多元回归分析确定基线TQ评分是治疗结果的重要预测因子。对于所有其他被调查的参数，没有发现统计学上显著的影响。结论：本研究提示左侧颞部低频rTMS对左侧耳鸣和双侧耳鸣有有益的治疗效果，但对右侧耳鸣无效。与早期涉及较小样本的研究结果一致，耳鸣持续时间被发现影响rTMS结果。
Background:There is increasing evidence that repetitive transcranial magnetic stimulation (rTMS) can reduce chronic tinnitus. However, treatment results are characterized by high interindividual variability. Therefore, the identification of predictors for treatment response is of high clinical relevance.Methods:Clinical data of 194 patients with tinnitus were evaluated. All patients were treated with a standardized rTMS procedure (1 Hz, 10 days, 2000 stimuli/day, over the left temporal cortex). A potential influence on the outcome was analysed for the following parameters: age, gender, depression scores in Beck Depression Inventory (BDI) and tinnitus severity (TQ) before rTMS, lateralization, frequency and duration of tinnitus and extent of hearing loss.Results:An effect of tinnitus laterality was observed. In patients with left-sided or bilateral tinnitus, rTMS resulted in a statistically significant reduction of TQ scores, whereas patients with right-sided tinnitus did not show a significant improvement after rTMS treatment. However, in correlation analyses, we found a trend which did not reach statistical significance that in the subgroup of treatment responders tinnitus duration influenced rTMS outcome. In addition, a multiple regression analysis identified the TQ score at baseline as a significant predictor for treatment outcome. For all other investigated parameters, no statistically significant effects were found.Conclusions:This study suggests that left temporal low-frequency rTMS has beneficial effects in left-sided and bilateral tinnitus, but not in right-sided tinnitus. In line with the results from earlier studies involving smaller samples, tinnitus duration was found to influence rTMS outcome.